Healthcare Provider Details
I. General information
NPI: 1306740220
Provider Name (Legal Business Name): CRESTWATER HEALTH AND REHAB PARKWAY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 SE CENTRAL PKWY
STUART FL
34994-3901
US
IV. Provider business mailing address
800 SE CENTRAL PKWY
STUART FL
34994-3901
US
V. Phone/Fax
- Phone: 772-287-9912
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
LINDA
WINTERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 772-287-9912